Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Thiamine, one of the B vitamins, plays an important role in energy metabolism and tissue building. When there is not enough thiamine in the diet, these basic energy functions are disturbed, leading to problems throughout the body. There are two major manifestations of thiamine deficiency, cardiovascular disease (wet beriberi) and nervous system disease (dry beriberi). Each can be caused by chronic alcoholism, malnutrition, diuresis, dialysis, and high carbohydrate intake.
The accompanying symptoms of thiamine deficiency may include weakness, irritability, nausea, vomiting, tingling, or loss of sensation in the hands and feet (peripheral neuropathy). Progressed symptoms include mental confusion and difficulties speaking or walking; these are often the precursor symptoms leading to coma and/or death.
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
Thiamine hydrochloride is the initial treatment of choice for beriberi. Successful treatment reverses the deficiency and alleviates most of the symptoms. Severe deficiencies may be treated with high doses of thiamine given by muscular injection.
Alternative treatments stress a diet rich in foods that provide thiamine and other B vitamins, such as brown rice, whole grains, raw fruits and vegetables, legumes, nuts and seeds, and yogurt. Additional supplements of B vitamins, a multivitamin and mineral complex, and vitamin C are also recommended. A balanced diet containing all essential nutrients will prevent thiamine deficiency and the development of beriberi. People who consume large quantities of soda, pretzels, chips, candy, and high-carbohydrate foods made with unenriched flours may also need vitamin supplements to avoid thiamine deficiency.
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The first clinical descriptions of beriberi were conducted by the Dutch physician Nicolaas Tulp around 1652. Tulp treated a young Dutchman who, upon returning from the East Indies, suffered from what the natives of the Indies called beriberi, or “the lameness.” Not until the early twentieth century did scientists discover that rice bran, the outer covering of white rice, actually contains something that prevented the disease, thiamine. In the 1920’s, extracts of rice polishings were used to treat the disease.
Beriberi is fatal if left untreated. Most symptoms can be reversed, and full recovery is possible when thiamine levels are returned to normal and maintained with a balanced diet and vitamin supplements as needed.
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Anderson, Jean, and Barbara Deskins. The Nutrition Bible. New York: William Morrow, 1997.
Behrman, Richard E., Robert M. Kliegman, and Hal B. Jenson, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia: Saunders/Elsevier, 2007.
Rivlin, Richard. “Vitamin Deficiency.” In Conn’s Current Therapy, edited by Robert E. Rakel and Edward T. Bope. Philadelphia: Saunders/Elsevier, 2007.
Williams, Sue Rodwell, and Eleanor D. Schlenker. Essentials of Nutrition and Diet Therapy. 9th ed. St. Louis, Mo.: Mosby/Elsevier, 2007.
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Beriberi (Encyclopedia of Medicine)
Beriberi is a disease caused by a deficiency of thiamine (vitamin B1) that affects many systems of the body, including the muscles, heart, nerves, and digestive system. Beriberi literally means "I can't, I can't" in Sing-halese, which reflects the crippling effect it has on its victims. It is common in parts of southeast Asia, where white rice is the main food. In the United States, beriberi is primarily seen in people with chronic alcoholism.
Beriberi puzzled medical experts for years as it ravaged people of all ages in Asia. Doctors thought it was caused by something in food. Not until the early 1900s did scientists discover that rice bran, the outer covering that was removed to create the polished white rice preferred by Asians, actually contained something that prevented the disease. Thiamine was the first vitamin identified. In the 1920s, extracts of rice polishings were used to treat the disease.
In adults, there are different forms of beriberi, classified according to the body systems most affected. Dry beriberi involves the nervous system; wet beriberi affects the heart and circulation. Both types usually occur in the same patient, with one set of symptoms predominating.
A less common form of cardiovascular, or wet beriberi, is known as...
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Beriberi (Encyclopedia of Neurological Disorders)
Beriberi is a condition caused by severe prolonged deficiency of vitamin B1 (also known as thiamine). Beriberi refers to a constellation of heart, gastrointestinal, and nervous system problems from thiamine deficiency.
Thiamine is found in a variety of foods, particularly whole grains, legumes, and pork. Thiamine serves as a coenzyme in the chemical pathway responsible for the metabolism of carbohydrates. Thiamine deficiency interferes with the metabolism of glucose and the production of energy.
Four major types of beriberi exist: wet beriberi, which affects primarily the cardiovascular system; dry beriberi, which affects primarily the nervous system; shoshin, which is a rapidly evolving and frequently fatal form of cardiovascular beriberi; and infantile beriberi, which tends to strike babies between the ages of one and four months who are breastfed by mothers who are severely thiamine deficient.
Because so many foods in the United States and other western countries are vitamin enriched, beriberi is extremely rare. In developed countries, beriberi is primarily a complication of malnutrition secondary to alcoholism or gastrointestinal disorders. Because alcoholism affects more males than females, rates of beriberi in...
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Beriberi (Encyclopedia of Food & Culture)
BERIBERI. Beriberi is a disease that usually begins with a loss of feeling in the feet and then weakness and pain in walking. In many, but not all, cases the body then becomes swollen and in the most serious cases the heart begins to fail, and the patient becomes breathless and soon dies. The problem stems from an insufficient intake of the vitamin thiamin (or "thiamine") even though we require each day only about 1 milligram, which is equivalent to one 32,000th of an ounce. The word "beriberi" comes from Indonesia and may mean "weak" or "swelling," but there have been many other suggested meanings.
The disease used to be a serious problem in Far Eastern countries where white rice was the staple food and people ate only small quantities of supplementary foods. Husked rice grains provide a reasonable amount of this vitamin, but further processing, or "polishing" to rub off the bran and germ, removes most of the remaining thiamin. Washing the grains and boiling them leaves even less thiamin in the final cooked food. Unfortunately, brown (unpolished) rice goes rancid more quickly under tropical conditions and so has only a short storage life. In traditional peasant communities, where enough paddy (unhusked grain) would be pounded and winnowed each morning for the day ahead, this was not a problem. When inexpensive power machinery for milling and polishing rice was developed, this made the provisioning of the armed forces in particular much more convenient, but in Japan and other Asian countries it was followed by serious outbreaks of beriberi in the army and navy.
Infantile beriberi also has been a major cause of death among breast-fed infants in the Philippines and other communities where mothers are in a state of borderline, subclinical thiamin deficiency. Affected infants typically cease to pass urine and experience difficulty in breathing. Even those near death, however, respond dramatically to a dose of thiamin.
It is technically possible now to mix in with white rice a few vitamin-rich pellets manufactured to resemble rice grains. However, where rice-growing communities each have their own small village mill, it has been found impracticable to control such additions, which slightly increase the millers' costs. As an alternative, communities at risk can be supplied with inexpensive vitamin pills.
In developed countries thiamin deficiency is still a problem among alcoholics, partly because such addicts have highly abnormal diet patterns and partly because they seem to absorb the vitamin less efficiently. They also may show acute heart problems without any early symptoms of traditional beriberi. A small proportion progress to a syndrome with irreversible brain damage that requires indefinite hospitalization.
In many Western countries, millers are required to fortify white wheaten flour with thiamin (along with other micronutrients). Thus, even the population groups, such as alcoholics, who are eating an unbalanced diet are less likely to become deficient. It also has been suggested that alcoholic drinks should be fortified with thiamin. This would not be prohibitively expensive, but authorities have felt that, on balance, it would be undesirable because it would allow them to be marketed as "health drinks" despite the injurious effects associated with or caused by alcohol consumption, that is, automobile accidents, disruption of families, and a wide range of health problems.
See also Dietary Assessment; Dietary Guidelines; Disease: Metabolic Diseases; Rice: Rice as a Food; Rice: The Natural History of Rice; Vitamins: Overview; Wheat.
Kenneth John Carpenter
Carpenter, K. J. Beriberi, White Rice, and Vitamin B. Berkeley: University of California Press, 2000.
Williams, R. R. Toward the Conquest of Beriberi. Cambridge, Mass.: Harvard University Press, 1961.